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NEUROLOGY 1997;49:686-689
© 1997 American Academy of Neurology

Erythropoietin-associated hypertensive posterior leukoencephalopathy

Norman Delanty, MD, Carl Vaughan, MD, Steven Frucht, MD and Patrick Stubgen, MD

From the Departments of Neurology (Drs. Delanty, Frucht, and Stubgen) and Medicine (Dr. Vaughan), New York Hospital, Cornell Medical Center, New York, NY.

Address correspondence and reprint requests to Dr. Norman Delanty, Department of Neurology, Hospital of the University of Pennsylvania, 3 West Gates, 3400 Spruce Street, Philadelphia, PA 19104-4283.

Human recombinant erythropoietin is used to treat chronic anemia in patients with end-stage renal failure. Erythropoietin causes hypertension, and hypertensive encephalopathy has been associated with its use. We describe six dialysis-dependent, chronic renal failure patients who developed hypertension, headache, and seizures while on erythropoietin. Four of the six patients had posterior white matter changes on neuroimaging. The encephalopathy was managed by prompt antihypertensive and anticonvulsant treatment and by discontinuation of erythropoietin. Hypertensive posterior leukoencephalopathy is associated with erythropoietin use.

Received January 23, 1997. Accepted in final form April 4, 1997.

Presented in part at the 49th American Academy of Neurology meeting in Boston, MA, April 1997.




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